Maryland Commission on Kidney Disease met July 26.
Here
The Public Meeting of the Commission on Kidney Disease was held on Thursday, July 26, 2018 at 4201 Patterson Avenue. Chairman, Dr. Jeremy Yospin called the meeting to order at 2:09 p.m. Commissioners Dr. Donna Hanes, Dr. Paul Segal, Dr.
Commission staff present: Eva Schwartz, Executive Director and Donna Adcock, RN, Surveyor
Commission Counsel present: Adam Malizio, AAG
MDH staff present: Brenda Petersen, RN and John Miller, RN – OHCQ Surveyors and Kim Lang,
Associate Director of Health Occupation Boards and Commissions
Guests
Kelly Morgan, Greg Hoey
Joanne Seader, Davita Pam Earll, Davita
Jessica Quintilian, NKF Jamie McNeill, Bon Secours
I. Ratify Approval Of The Minutes Of The Public Session of May 3, 2018
Commissioner Wise motioned to ratify the approval of the Public Minutes from the May 3rd session. Commissioner Hanes seconded the motion and the Commission voted unanimously to ratify the approval the Minutes of the May 3, 2018 Public Session.
II. Chairman’s Report
Dr. Yospin discussed new legislation enacted July 1st regarding prescribing controlled substances including Opioids. He noted that this legislation would impact the nephrologists and dialysis facilities as some of the nephrologists also act as primary care physicians. Dr. Yospin reported on the requirements to comply with the law and need to keep patients safe. He discussed the Prescription Drug Monitoring Program (PDMP) and Continuous Readiness in Information Security Program (CRISP) programs. Discussion ensued.
III. Executive Director’s Report
• Discussion Regarding the Assigning of an Infection Control “Officer” in a Facility
Mrs. Schwartz reported on the repetitive infection control findings during facility surveys. Discussion ensued. Ms. McNeil noted that Bon Secours has a system where staff are observed and results of the observations are considered during compensation reviews.
VI. New Business
A. Kidney Disease Program
• Stats and Budget
Dr. Yospin reviewed the submitted KDP budget report.
• KDP Benefits
Mrs. Schwartz directed the guests’ attention to the attachments – Kidney Disease Program Financial Assistance and Coverage and KDP Reimbursable Services Not Covered by Medicare. She reminded guests to inform patients of the KDP and KDP benefits. She noted that facilities must be certified by the Commission in order for the facility and their patients to receive benefits. The attachments are also posted on the Commission website. Dr. Yospin noted that most of the KDP budget is paid to the dialysis facilities.
B. End of Life Issues for Dialysis Patients
Dr. Segal presented end of life issues and discussed palliative and hospice care for dialysis patients. He noted that future CMS core measures may include hospice and palliative care. Ms. Collins reported that Kaiser offers advanced care planning to members and nonmembers on their website (kp.org).
C. Change in Commission Membership Qualifications for Governor's Appointment Purposes
Mrs. Schwartz reported that legislation has been proposed to remove the restriction for individuals to be appointed to serve on the Commission if they have direct ownership in renal dialysis facilities. She noted that the restriction prevented good candidates from appointment to the Commission as most nephrologists have some ownership in dialysis facilities. Ms. Schwartz stated that the bill would also reduce the minimum number of submitted names required per position from 3 to 2.
D. Network Update
Mrs. Adcock directed the guest attention to the Network Summary Report. The Network provided a summary of their projects, grievance and involuntary discharges.
E. Expanding the Kidney Donor Pool with Hepatitis C Positive Donors Mrs. Adcock directed the guests’ attention to the Expanding the Kidney Donor Pool with Hepatitis C- Positive Donors paper. A recent study lead by Johns Hopkins could increase the availability of organs including kidneys for transplant by transplanting Hepatitis C positive organs into patients who are negative for the virus and treating the recipient for Hepatitis C.
F. Citation Free Surveys
Dr. Yospin commended the follow facilities for achieving citation free surveys:
• Nx Stage West
• JHH Transplant
G. Non- Renewed Facilities
Dr. Yospin reported that the following facilities have elected not to renew their certification:
• FMC S. Annapolis
• FMC Prince George
• FMC Ft. Foote
• FMC Hyattsville
• FMC Orleans Non-certified facilities and their patients are excluded from receiving KDP benefits. A list of certified and uncertified facilities is located on the Commission’s website.
H. Categories of Complaints
Dr. Yospin reported that since the last meeting the Commission has received and resolved the following types of complaints:
Written
• Patient complaint regarding care at a facility
Verbal
1. Physician complaint regarding an abusive patient
2. Patient family member complaint regarding facility placement
3. Patient complaints regarding care at facilities
I. Commission Approval/Disapproval for KDP Out of State Transplant Reimbursement This quarter, the Commission has received and granted 7 out of state transplant prior approvals, for KDP reimbursement purposes.
Hospital – Granted - Refused
MedStar Georgetown Transplant Center 3 0
Christiana Transplant Center 1 0
George Washington University Transplant 2 0
Inova Fairfax Transplant 1 0
J.Surveys
Citations
Compliance with Federal, State and Local Laws and Regulations 0
Infection Control 15
Water and Dialysate Quality 6
Physical Environment 2
Patient Rights 0
Patient Assessment 2
Patient Plans of Care 6
Care at Home 0
Quality Assessment and Performance
Improvement 0
Laboratory/Affiliation Guidelines 0
Personnel Qualifications/Staffing 12
Responsibilities of the Medical Director 0
Medical Records 1
Governance 2
For informational purposes, the Commission shared the results of their survey findings deficiency report for the past quarter. It was noted that infection control and personnel qualifications/staffing continue to be areas that facilities should focus on improving.
K.Surveys Completed
The following 22 facilities have been surveyed since the last meeting:
Davita Cedar Lane, USRC Clinton
Nx Stage West, Davita Cambridge
Davita Easton Advanced Easton
Holy Cross ,ARA Adelphi
Davita Howard County, ARA Ellicott Kidney
FMC Rockville, Deer’s Head
FMC Salisbury, Davita Brandywine
FMC White Marsh, Davita Lakeside
IDF Chestnut, FMC Rosedale
JHH Transplant, Davita Good Samaritan
Davita White Square, Holy Cross Woodmore
There being no further public business, upon motion made by Commissioner Segal and seconded by Commissioner Wise, the Commission unanimously voted to adjourn the Public Session at 3:30 p.m.
https://health.maryland.gov/mdckd/Documents/mins0718.pdf
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